Abstract
BackgroundThe Seattle Angina Questionnaire (SAQ) is a widely-used patient-reported outcomes measure in patients with heart disease. This study assesses the validity and reliability of the SAQ in a Canadian cohort of individuals with stable angina.Methods and resultsData are from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry, a population-based registry of patients who received cardiac catheterization in Alberta, Canada. The cohort consists of 4052 patients undergoing cardiac catheterization for stable angina and completed the SAQ within 2 weeks. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to assess the factorial structure of the SAQ. Internal and test–retest reliabilities of a new measure (i.e., SAQ-CAN) was measured using Cronbach α and intraclass correlation coefficient, respectively. CFA model fit was assessed using the root mean square error of approximation (RMSEA) and comparative fit index (CFI). Construct validity of the SAQ-CAN was assessed in relation to Hospital Anxiety and Depression Scales (HADS), Euro Quality of life 5 dimension (EQ5D), and original SAQ. Of the 4052 patients included in this analysis, 3281 (80.97%) were younger than 75 years old, while 3239 (79.94%) were male. Both exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 16 items that provided a better fit to the data (RMSEA = 0.049 [90% CI = (0.047, 0.052)]; CFI = 0.975). The 16-item SAQ demonstrated good to excellent internal reliability (Cronbach’s α range from 0.77 to 0.90), moderate to strong correlation with the Original SAQ and EQ5D but negligible correlations with HADS.ConclusionThe SAQ-CAN has acceptable psychometric properties that are comparable to the original SAQ. We recommend its use for assessing coronary health outcomes in Canadian patients with Coronary Artery Disease.
Highlights
Heart disease, the second-leading cause of death in Canada, affects up to 8.5% [1] of adult Canadians and accounts for an annual estimated cost of $21.2 billion [2]
The Seattle Angina Questionnaire (SAQ)-CAN has acceptable psychometric properties that are comparable to the original SAQ
We recommend its use for assessing coronary health outcomes in Canadian patients with Coronary Artery Disease
Summary
The second-leading cause of death in Canada, affects up to 8.5% [1] of adult Canadians and accounts for an annual estimated cost of $21.2 billion [2]. Lawal et al Health Qual Life Outcomes (2020) 18:377 quality of life (HRQOL) [3] Professional societies, such as the American Heart Association, have advocated integrating patients’ perspectives of their health status as a key cardiovascular health outcome that should be used in clinical trials of new interventions, observational studies, and routine clinical practice [4]. Several patient-reported outcome measures have been developed for measuring symptoms burden, functional status, and quality of life in people with CAD. The Seattle Angina Questionnaire (SAQ), a widely used disease-specific measure of quality of life in patients with heart disease, is a 19-item self-administered questionnaire that measures 5 dimensions of HRQOL [7]. This study assesses the validity and reliability of the SAQ in a Canadian cohort of individuals with stable angina
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